Please Print this form, complete, and mail copy with your check to:

Central Coast Scottish Society

PO Box 13954

San Luis Obispo, CA 93406

If you have any questions, please contact:

Ron Parker (Membership Chairman)

membership@sloscots.com or call

(805) 239-9569

Last Name:

First:

Spouse:

Children:

Ages:

Birth Months (circle all that apply)

    Jan       Feb       Mar        Apr

    May      Jun       Jul         Aug

    Sep      Oct       Nov        Dec

Occupation:

Address:

City:

State:

CLAN:

Home Phone:

Zip

Email:

Cell Phone:

Date:

Family Membership

$25.00

Single Membership

$22.50

Student Membership

$12.00

Lifetime Membership

$200.00

Bag Pipes

Meeting New Friends

Scottish Country Dancing

Celtic & Clan History

Movies (Rob Roy, Braveheart)

Scottish History

Crafts

Music

Scottish Cooking

Gaelic

Potlucks

Scottish Whisky

Genealogy

Re-enactments

Socializing

Highland Dancing

Robert Burns

Tartans & Highland Attire

Highland Games

Scottish Athletics

Travel

Other Interests (please list)